Premium
Subacute airway obstruction from a tracheal mucosal flap
Author(s) -
Farr M. J.,
Cyna A. M.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04508.x
Subject(s) - medicine , stridor , bronchoscopy , airway obstruction , tracheal intubation , intubation , tracheomalacia , respiratory distress , surgery , airway , tracheal tube , airway management , anesthesia
Summary We report the case of a 15‐year‐old girl with a near fatal obstructive tracheal lesion following tracheal intubation. The patient developed stridor and acute respiratory distress 29 h following tracheal extubation, after 35 h intubation in the intensive care unit. The failure of conventional management of stridor, including re‐intubation, to provide a satisfactory airway prompted an urgent bronchoscopy, which revealed a tracheal mucosal flap causing 80% obstruction of the subglottic trachea. The fibreoptic bronchoscope allowed careful placement of a tracheal tube distal to the obstruction. The patient eventually made a full recovery. The low incidence of similar lesions and the lack of distinguishing clinical features from other causes of post‐extubation stridor make diagnosis and appropriate management of this life‐threatening condition difficult. We discuss how early consideration of the diagnosis and optimal initial management reduce the risk of an adverse outcome.